Decreasing Unnecessary Antibiotic Usage in Patients Admitted With Bronchiolitis

Author:

Naeem Fouzia12,Kuzmic Brenik3,Khang Leepao4,Osburn T. Shea15

Affiliation:

1. Department of Pediatrics and

2. Divisions of Infectious Diseases

3. Pharmacy, Valley Children’s Healthcare, Madera, California

4. Department of Public Health, California State University, Fresno, California

5. Hospital Medicine

Abstract

BACKGROUND AND OBJECTIVES Bronchiolitis is a viral syndrome that occurs in children aged <2 years and is a common reason for admission to children’s hospitals. The American Academy of Pediatrics bronchiolitis guideline discourages routine antibiotic therapy for bronchiolitis. Despite this, there is high use of antibiotics in this patient population. METHODS We performed a retrospective chart review of all patients aged ≤2 years admitted to our tertiary care center with bronchiolitis during 2 subsequent respiratory seasons. Between the 2 seasons, we provided an intervention to our hospital medicine group, which included a didactic review of American Academy of Pediatrics bronchiolitis guideline followed by subsequent, ongoing reinforcement from antibiotic stewardship weekday rounds. RESULTS We were able to achieve a 40% decrease in overall antibiotic use between the 2 study periods (25% vs 15%, P < .001). CONCLUSIONS Provider education, along with focused antibiotic stewardship audits with real-time feedback, resulted in decreased use of antibiotics in patients admitted with bronchiolitis.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics,General Medicine,Pediatrics, Perinatology, and Child Health

Reference17 articles.

1. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis [published correction appears in Pediatrics. 2015;136(4):782];Ralston;Pediatrics,2014

2. Antibiotic treatment of pneumonia and bronchiolitis. A prospective randomised study;Friis;Arch Dis Child,1984

3. Antibiotics for bronchiolitis in children;Spurling;Cochrane Database Syst Rev,2011

4. Low risk of bacteremia in febrile children with recognizable viral syndromes;Greenes;Pediatr Infect Dis J,1999

5. Bronchodilators for bronchiolitis;Gadomski;Cochrane Database Syst Rev,2014

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